MO966COGNITIVE FUNCTIONING AMONG VARIOUS MODALITIES OF RENAL REPLACEMENT THERAPY- ROLE OF RENAL TRANSPLANT

Abstract Background and Aims Evidences have shown diverse responses on thedescription of cognitive function in patients who have undergone renaltransplantation. The present study examined the changes in cognitive functionamong ESRD patients on maintenance haemodialysis or on CAPD and followingthey post renal transplant. We also looked into the ccognitive status among frailand non frail ESRD patients and their performance in the post transplant period Method 67 patients who were stable ESRD on thrice a week haemodialysis or onCAPD were investigated 6 months pre and post transplant using a battery ofneurophysiologic testing. Transplant function was assessed on regular interval andfollowing a stable graft function and on stable doses of immunosuppressive medication 6 months post transplant. Results CAPD compared to HD had better preservation of cognitive functionsassessed 6 months after initiation of dialysis. There was statistically significantimprovement in general cognitive status performance (P < 0.001), motor speed,spatial reasoning, verbal memory and visual memory post transplant compared tothe pre transplant state. However, non-significant improvements were observed indomains of attention, executive functioning, language and verbal fluency. Theanxiety and depression scores did not show significant improvement despitetransplant. On the basis of fraility, frail individuals experienced less improvement in cognitive function as compared to non frail recipients in our study. Conclusion The data demonstrate improvements in cognition following kidneytransplant and emphasize the reversibility of the memory problems evidencedamong patients on dialysis.Focus should be made for interventions in terms ofprevention of cognitive decline among frail patients very early in pre-end stage thus helping in overall outcomes post transplant.

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Calcium and phosphate levels after kidney transplantation and long-term patient and allograft survival

Clinical Kidney Journal ◽

10.1093/ckj/sfaa061 ◽

2020 ◽

Author(s):

Julio Chevarria ◽

Donal J Sexton ◽

Susan L Murray ◽

Chaudhry E Adeel ◽

Patrick O’Kelly ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Graft Failure ◽

Graft Function ◽

Renal Transplant Recipients ◽

Post Transplant ◽

All Cause Mortality ◽

Transplant Function ◽

The Republic ◽

The Impact

Abstract Background Non-traditional cardiovascular risk factors, including calcium and phosphate derangement, may play a role in mortality in renal transplant. The data regarding this effect are conflicting. Our aim was to assess the impact of calcium and phosphate derangements in the first 90 days post-transplant on allograft and recipient outcomes. Methods We performed a retrospective cohort review of all-adult, first renal transplants in the Republic of Ireland between 1999 and 2015. We divided patients into tertiles based on serum phosphate and calcium levels post-transplant. We assessed their effect on death-censored graft survival and all-cause mortality. We used Stata for statistical analysis and did survival analysis and spline curves to assess the association. Results We included 1525 renal transplant recipients. Of the total, 86.3% had hypophosphataemia and 36.1% hypercalcaemia. Patients in the lowest phosphate tertile were younger, more likely female, had lower weight, more time on dialysis, received a kidney from a younger donor, had less delayed graft function and better transplant function compared with other tertiles. Patients in the highest calcium tertile were younger, more likely male, had higher body mass index, more time on dialysis and better transplant function. Adjusting for differences between groups, we were unable to show any difference in death-censored graft failure [phosphate = 1.14, 95% confidence interval (CI) 0.92–1.41; calcium = 0.98, 95% CI 0.80–1.20] or all-cause mortality (phosphate = 1.10, 95% CI 0.91–1.32; calcium = 0.96, 95% CI 0.81–1.13) based on tertiles of calcium or phosphate in the initial 90 days. Conclusions Hypophosphataemia and hypercalcaemia are common occurrences post-kidney transplant. We have identified different risk factors for these metabolic derangements. The calcium and phosphate levels exhibit no independent association with death-censored graft failure and mortality.

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Characteristics of neurocognitive functions in mild cognitive impairment with depression

International Psychogeriatrics ◽

10.1017/s1041610216000314 ◽

2016 ◽

Vol 28 (7) ◽

pp. 1181-1190 ◽

Cited By ~ 9

Author(s):

Hyun-Seok Dong ◽

Changsu Han ◽

Sang Won Jeon ◽

Seoyoung Yoon ◽

Hyun-Ghang Jeong ◽

...

Keyword(s):

Processing Speed ◽

Verbal Memory ◽

Neuropsychological Tests ◽

Visual Memory ◽

Strong Association ◽

Cognitive Status ◽

Memory Recall ◽

Major Depressive ◽

Neurocognitive Functions ◽

General Cognitive Status

ABSTRACTBackground:Previous studies suggest that there is a strong association between depression and cognitive decline, and that concurrent depressive symptoms in MCI patients could contribute to a difference in neurocognitive characteristics compared to MCI patients without depression. The authors tried to compare neurocognitive functions between MCI patients with and without depression by analyzing the results of neuropsychological tests.Methods:Participants included 153 MCI patients. Based on the diagnosis of major depressive disorder, the participants were divided into two groups: depressed MCI (MCI/D+) versus non-depressed MCI (MCI/D−). The general cognitive and functional statuses of participants were evaluated. And a subset of various neuropsychological tests was presented to participants. Demographic and clinical data were analyzed using Student t-test or χ2 test.Results:A total of 153 participants were divided into two groups: 94 MCI/D+ patients and 59 MCI/D− patients. Age, sex, and years of education were not significantly different between the two groups. There were no significant differences in general cognitive status between MCI/D+ and MCI/D− patients, but MCI/D+ participants showed significantly reduced performance in the six subtests (Contrasting Program, Go-no-go task, Fist-edge-palm task, Constructional Praxis, Memory Recall, TMT-A) compared with MCI/D− patients.Conclusions:There were significantly greater deficits in neurocognitive functions including verbal memory, executive function, attention/processing speed, and visual memory in MCI/D+ participants compared to MCI/D−. Once the biological mechanism is identified, distinct approaches in treatment or prevention will be determined.

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Concussion History and Cognitive Function in a Large Cohort of Adolescent Athletes

The American Journal of Sports Medicine ◽

10.1177/0363546518798801 ◽

2018 ◽

Vol 46 (13) ◽

pp. 3262-3270 ◽

Cited By ~ 4

Author(s):

Kathryn M. Taylor ◽

Marianthi-Anna Kioumourtzoglou ◽

Jim Clover ◽

Brent A. Coull ◽

Jack T. Dennerlein ◽

...

Keyword(s):

High School ◽

Cognitive Function ◽

Verbal Memory ◽

Impulse Control ◽

Visual Memory ◽

Test Battery ◽

Cognitive Test ◽

Effect Estimate ◽

Cognitive Score ◽

And Performance

Background: The incidence of reported concussions in the adolescent population is increasing, yet research on the effects of concussions in this population is minimal and inconclusive. Purpose: To assess the association between concussion and performance on a cognitive test battery. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Using multivariate models, the authors assessed the association between concussion and performance on a cognitive test battery among 5616 high school and junior high school athletes. The researchers utilized a global cognitive score and scores for 5 domains: verbal memory, visual memory, visual motor, reaction time, and impulse control. Each cognitive score was converted to a z score with the mean and SD of the nonconcussed population. Results from each model were then interpreted as change in the standardized unit score. In the models, concussion was evaluated as ever having a concussion, number of concussions, time since last concussion, and age at first concussion. Results: Ever having a concussion was associated with a mean decrease of 0.11 standardized units (95% CI, −0.20 to −0.01) on the global cognitive score and lower scores in all cognitive domains. Each additional concussion was associated with lower scores on global cognitive function (effect estimate, −0.06; 95% CI, −0.11 to −0.02), verbal memory, visual memory, and impulse control. Concussion in early childhood was associated with lower global cognition (effect estimate, −0.05; 95% CI, −0.08 to −0.01), visual memory, and motor visual scores as compared with concussions in later childhood. The associations between time since last concussion and cognitive test scores were nonlinear, and on all tests, lower scores were observed even ≥1 year after the concussion. Conclusion: On the basis of objective performance metrics for cognitive function, concussions had a more persistent effect on cognitive function than previously thought. The age at which an individual has his or her first concussion may be an important factor in determining long-lasting cognitive effects.

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B-44 An Examination of Balance Measurements in Predicting Post-Concussion Neurocognitive Dysfunction

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz034.127 ◽

2019 ◽

Vol 34 (6) ◽

pp. 990-990

Author(s):

A DaCosta ◽

A Crane ◽

M Fasciana ◽

A LoGalbo

Keyword(s):

Reaction Time ◽

Verbal Memory ◽

Visual Memory ◽

Clinical Utility ◽

Collegiate Athletes ◽

Motor Speed ◽

Balance Performance ◽

Neurocognitive Dysfunction ◽

Balance Deficits ◽

Visual Motor

Abstract Objective Previous research indicates that athletes experiencing concussions demonstrate acute balance deficits (Guskiewicz, 2011). Although it is hypothesized that balance performance is related to neurocognitive function in athletes experiencing a concussion (Guskiewicz, Ross, & Marshall, 2001; Broglio, Sosnoff, Ferrara, 2009), limited research exists regarding the clinical utility of baseline measures. Method 68 collegiate athletes (ages 18-23; M = 19.62, SD = 1.44) were evaluated using the Balance error scoring system (BESS) and ImPACT at baseline and post-concussion. Multiple linear regressions were used to determine how BESS performance change across evaluations predicted post-concussion neurocognitive dysfunction compared to post-concussion performance alone. Results BESS performance changes from baseline to post-concussion significantly predicted post-concussion Verbal Memory (R² = .06, p = .05), Visual Memory (R² = .135, p = .002), Visual-Motor Speed (R² = .146, p = .001), Reaction Time (R² = .156, p = .001), and Total Symptom Scores (R² = .112, p = .005); while post-concussion BESS scores predicted Visual Memory (R² = .138, p = .002), Visual-Motor Speed (R² = .137, p = .002), and Reaction Time (R² = .145, p = .001). Therefore, assessing change in BESS performance is a more comprehensive predictor of neurocognitive dysfunction than solely post-concussion BESS performance. Conclusions Changes in BESS performance from baseline to post-concussion was found to be a more comprehensive predictor of neurocognitive dysfunction than post-concussion BESS scores alone. Therefore, our results support the clinical utility of evaluating balance at pre-participation to better understand neurocognitive risk factors.

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TO004IMPACT OF RENAL TRANSPLANT ON COGNITIVE FUNCTION AMONG ESRD PATIENTS ON DIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa141.to004 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Anupma Kaul ◽

Dharmendra Bhaduria ◽

Narayan Prasad ◽

Amit Gupta

Keyword(s):

Cognitive Function ◽

Kinetic Modelling ◽

Memory Performance ◽

Graft Function ◽

Post Transplant ◽

Formal Kinetic ◽

Psychomotor Ability ◽

Normative Comparisons ◽

Stage Renal Disease ◽

End Stage

Abstract Background and Aims Kidney transplantation can help in mitigating neuropsychological (NP) impairments in end-stage renal disease (ESRD). Evidences have shown mixed responses on the the nature of cognitive function in patients who have undergone renal transplantation.Present study looked into the factors impacting cognitive domains and impact post transplant. Method 43 patients who were stable ESRD on thrice a week hemodialysis were investigated 6 months pre and post transplant using a battery of neurophysiological testing assessing attention–concentration, psychomotor ability and memory. Formal kinetic modelling of dialysis delivery ensured adequate renal replacement therapy. Transplant function was assessed on regular interval and following a stable graft function and on stable doses of immunosuppressive medication 6 months post transplant were reassessed Results Within-subject comparisons showed statistically significant improvement in memory performance after kidney transplant. Other NP measures (attention– concentration and psychomotor abilities) showed non-significant improvements. Normative comparisons showed NP impairments on dialysis, which were not apparent after transplant Conclusion These data demonstrate improvements in cognition following kidney TX and emphasize the reversibility of the memory problems evidenced in dialysis

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Association between Shift Work and Neurocognitive Function among Firefighters in South Korea: A Prospective before–after Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17134647 ◽

2020 ◽

Vol 17 (13) ◽

pp. 4647 ◽

Cited By ~ 1

Author(s):

Kyeongmin Kwak ◽

Bong-Kyu Kim ◽

Tae-Won Jang ◽

Chang Sun Sim ◽

Yeon-Soon Ahn ◽

...

Keyword(s):

South Korea ◽

Shift Work ◽

Verbal Memory ◽

Visual Memory ◽

Night Shift ◽

Neurocognitive Function ◽

Night Work ◽

Motor Speed ◽

Before And After ◽

Fire Stations

Background: Recent research indicates that shift work is associated with neurocognitive function. However, studies that examine the association between shift work and neurocognitive function in firefighters have not yet been performed. We examined the effect of shift work on neurocognitive function in firefighters by measuring and comparing neurocognitive function before and after night shift. Methods: 352 firefighters from eight fire stations in South Korea were included in this study. We performed neurocognitive function test using central nervous system vital signs (CNSVS) during daytime work and on the next day after night work. We performed paired t-tests to assess differences between neurocognitive function before and after night work. We also compared neurocognitive function in insomnia and depression. We used a general linear model to analyze the associations between shiftwork schedule and the changes in neurocognitive function. Results: The neurocognitive function significantly decreased in six domains (composite memory, verbal memory, visual memory, complex attention, psychomotor speed, and motor speed) as did the neurocognitive index on the next day after night work compared with during day work. These decreased domains were the same following night work regardless of the type of shift work. Conclusion: Night work in firefighters may cause neurocognitive decline.

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The Relation Between Cognitive Performance and Symptom Factors Following Concussion

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acz026.34 ◽

2019 ◽

Vol 34 (5) ◽

pp. 764-764

Author(s):

E Whitley ◽

R Gerkin ◽

A Kontos ◽

C Quintana ◽

B Nalepa ◽

...

Keyword(s):

Cognitive Performance ◽

Verbal Memory ◽

Visual Memory ◽

Injury Severity ◽

Clinical Importance ◽

Retrospective Chart Review ◽

Symptom Assessment ◽

Cognitive Outcomes ◽

Motor Speed ◽

And Gender

Abstract Purpose The purpose of this study was to explore if symptom factors are related to cognitive outcomes. Prior studies have examined the relationship of individual symptoms to cognition. However, the relation between empirically-derived symptom factors and cognitive outcomes has yet to be explored. Methods Data were extracted via retrospective chart review of 691 patients (aged 10–24, mean: 14.99±2.63). Participants completed ImPACT and the PCSS within 14 days of injury (mean: 9.27±3.37). Predictors were PCSS factor scores of Cognitive-Fatigue-Migraine (CFM), Affective (AFF), Somatic (SOM), and Sleep (SLP) (Kontos et al., 2012). Outcomes examined were ImPACT composite scores. Univariate analyses were performed and values with p < 0.10 were entered into stepwise linear regression (LR) models. Retained predictors in each LR model had p values <.05. Results Verbal memory was predicted by CFM, SOM, age, and gender. Visual memory was predicted by CFM and SOM. Visual motor speed was predicted by age, gender, CFM, SOM, and AFF. Reaction time was best predicted by SOM, CFM, and age. The variance explained was fairly small (0.08 to 0.21). SLP was not a significant predictor in any LR. Conclusion CFM and SOM factors were most predictive of lower cognitive performance, similar to prior studies linking dizziness to longer recovery and post-traumatic migraine to worse cognitive performance. These findings underscore the clinical importance of diverse symptom assessment and injury education. Higher CFM and SOM scores may also serve as proxy for injury severity, which we would expect to be associated with worse cognitive performance.

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THE RELATIONSHIP BETWEEN ACUTE MOOD, SLEEP, AND SEX ON NEUROCOGNITIVE PERFORMANCE POST-CONCUSSION IN ADOLESCENTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00191 ◽

2020 ◽

Vol 8 (4_suppl3) ◽

pp. 2325967120S0019

Author(s):

Sara Stremlau ◽

Richard Cameron Allred ◽

Richard Gerkin ◽

Steven Erickson ◽

Jamie Pardini

Keyword(s):

Reaction Time ◽

Verbal Memory ◽

Visual Memory ◽

Cognitive Testing ◽

Motor Speed ◽

Neurocognitive Performance ◽

Symptom Report ◽

Mood Symptoms ◽

Visual Motor ◽

And Performance

Background: Both sleep disturbance and mood changes are common symptoms post-concussion (Sell & Rubeor, 2017). Studies have found these symptoms are correlated with poorer performance on neurocognitive testing (Kontos et al., 2012 and Kostyun et al., 2015). In addition, Brown et al., (2015) showed that females report more symptoms at both baseline and post-concussion compared to males on the Post-Concussion Scale and the Sport Concussion Assessment Tool 2. Hypothesis/Purpose: The purpose of this study is to investigate how a patient’s sex, as well as self-reported acute mood and sleep symptoms are related to neurocognitive performance in individuals with concussion. Methods: Data were acquired through IRB-approved retrospective chart review. Composite scores from the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computerized evaluation and self-reported symptom scores on the Post-Concussion Symptom Scale were gathered for 1619 adolescents age 12-18 (49.3% female) who presented to a large metropolitan outpatient clinic for treatment of concussion. Results: Females endorsed higher overall symptoms (x=19.52, SD 19.37, median 13.0 for females; x=12.88, SD 15.89, median 7.0 for males; Mann-Whitney U Test p<0.001). This same pattern emerged for the mood and sleep symptom clusters (female mood mean=2.92, SD 4.51; male mood mean=1.64, SD 3.34; female sleep mean=1.59, SD 2.0; male sleep mean=1.11, SD 1.84; both Independent Samples Mann-Whitney U Tests ps<0.001). There were significant but modest negative correlations between mood symptoms and performance on verbal memory (r=-0.174), visual memory (r=-0.213), and visual motor speed (r=-0.146) composites (all ps<0.01). There was positive correlation between reaction time composite and mood symptoms (r=0.191). There were significant but modest negative correlations between sleep symptoms and performance on verbal memory (r=-0.171), visual memory (r=-0.184), and visual motor speed (r=-0.161) composites (all ps<0.01). There was a positive correlation between reaction time composite and sleep symptoms (r=0.196, p<0.01). Conclusion: Consistent with prior research, adolescent females reported more symptoms post-concussion, including total symptom score, mood symptoms, and sleep symptoms. Adolescents presenting with more mood and sleep symptoms demonstrated poorer performance on neurocognitive testing. However, given the modest nature of the correlation, a significant amount of variation in test performance is not explained by symptom report. Results from this study underscore the importance of a multidimensional concussion assessment that includes both symptom report and cognitive testing when working with pediatric athletes. This study also reinforces the importance of understanding potential effects of sleep, mood, and sex on concussion.

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The stability of ImPACT baseline test performance over a 3-year period in high school athletes

Neurology ◽

10.1212/01.wnl.0000550636.18771.12 ◽

2018 ◽

Vol 91 (23 Supplement 1) ◽

pp. S7.2-S7

Author(s):

Nicholas Erdman ◽

Samuel Walton ◽

Jeremy Eith ◽

Lizzie Leitch ◽

Joanna Shutzer ◽

...

Keyword(s):

High School ◽

Verbal Memory ◽

Repeated Measures ◽

Visual Memory ◽

Intraclass Correlation ◽

Baseline Assessment ◽

Motor Speed ◽

Group Setting ◽

The Stability ◽

Subject Differences

PurposeAnnual baseline assessment using computerized neurocognitive tests have been recommended by governing healthcare bodies for the management of sport-related concussion but is supported by limited evidence. The current study examined the stability of ImPACT performance across three-successive years in adolescent athletes.MethodThis prospective cohort included 229 (117 male, 112 female) high school student-athletes from 2 private high schools. ImPACT was administered in a controlled group setting (1–17 participants) at years 1 (T1; n = 229), 2 (T2; n = 101) and 3 (T3; n = 47). Repeated measures analyses of variance (ANOVA 4 × 3) were used to examine performance on ImPACT's Verbal Memory (VEM), Visual Memory (VIS), Visual Motor Speed (VMS), and Reaction Time (RT) composite scores. Paired t-tests were used for post-hoc analyses. Two-way mixed intraclass correlation coefficients (ICC [3,1]) with 95% confidence intervals (CI) were calculated between time points. Group mean and within-subject differences between each time point for ImPACT scores were analyzed using manufacturer provided reliable change indices (RCI). All analyses were performed with alpha = 0.05.ResultsA significant main effect was observed for VMS (F [2,92] = 27.90, p = 0.001) across time. Participants significantly improved on VMS between T2 and T1 (t [100] = 4.15, p = 0.001), T3 and T2 (t [46] = 7.19, p = 0.001), and T3 and T1 (t [46] = 3.85, p < 0 .001). Weak (VEM: ICC = 0.37, CI = 0.19, 0.55) to strong (VMS: ICC = 0.83, CI = 0.74, 0.90) ICCs were observed for ImPACT scores. No group mean differences exceeded the 80% CI for ImPACT's RCI, although within-subject differences for at least 1 score exceeded the 80% CI between T2 and T1 (24%–39%), T3 and T2 (26%–45%), and T3 and T1 (32%–51%).ConclusionsOverall, statistically significant improvement was observed for VMS, however, the magnitude of the change may not be clinically meaningful. Similar to previous research, reliability of ImPACT scores ranged from weak to strong. Our results support annual baseline assessment of young athletes for progression of neurocognitive functioning.

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Cognitive function in female patients with schizophrenia and metabolic syndrome

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.070 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S97-S97 ◽

Cited By ~ 3

Author(s):

A.C. Botis ◽

I. Miclutia ◽

N. Vlasin

Keyword(s):

Metabolic Syndrome ◽

Cognitive Function ◽

Verbal Memory ◽

Cognitive Impairments ◽

Motor Speed ◽

Female Patients ◽

Speed Of Information Processing ◽

Brief Assessment ◽

The Metabolic Syndrome ◽

Competing Interest

IntroductionThe metabolic syndrome (MetS) and cognitive impairments, both related with poor outcomes in schizophrenia, are common in patients with this disorder. MetS has been associated with cognitive impairments in schizophrenia, but there is no general consensus regarding the description of various domains of neurocognition in patients with schizophrenia related to MetS.ObjectivesThe goal of this study was to assess cognitive functions in female patients with schizophrenia complicated by metabolic syndrome compared to those with schizophrenia without metabolic syndrome.MethodsFifty-four female patients diagnosed with schizophrenia were divided into two groups: MetS group (MetS+) and non-MetS group (MetS−). Cognitive functioning were investigated using the Brief Assessment of Cognition in Schizophrenia (BACS).ResultsTwenty-seven (52%) patients with schizophrenia met criteria for the MetS diagnosis. Mean age of patients was 40.80. Patients from MetS+ group performed significantly worse on verbal memory (P = 0.005), executive functions (P = 0.028) and motor speed (P = 0.035) as compared to MetS− group. Patients with schizophrenia who were hypertensive showed cognitive impairments in 2 domains of cognition: attention and speed of information processing (P = 0.004) and verbal fluency (P = 0.001). Patients with hypertriglyceridemia performed significantly worse on verbal memory (P = 0.005). Motor speed was associated with waist circumference (P = 0.02).ConclusionsAt a mean age of 40 years old, female patients with schizophrenia and metabolic syndrome show difficulties in more domains of cognitive function compared to female patients with schizophrenia without metabolic syndrome. Our findings suggest a link between cognition and metabolic syndrome in female patients with schizophrenia.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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